Variable angle locking insert for intramedullary nail

Abstract

A system including an intramedullary nail and an insert dimensioned to be positioned within the intramedullary nail. The insert can include a rotating component configured to rotate about a rotational axis transverse to a longitudinal axis of the intramedullary nail. The insert can be configured to receive a bone screw, rotate about the rotational axis as the bone screw is positioned at a selected angle of a plurality of angles relative to the intramedullary nail, and lock the bone screw at the selected angle.

What is claimed is: 
     
       1. A method, comprising:
 inserting a bone screw through a first elongated opening of a through bore defined by an intramedullary nail, wherein the first elongated opening is configured to permit the bone screw to extend through the first elongated opening at a plurality of angles relative to the intramedullary nail; and 
 inserting the bone screw through an insert, wherein the insert is configured to lock the bone screw at a selected angle of the plurality of angles, wherein the insert is positioned completely within a lumen extending along a longitudinal axis of the intramedullary nail; and 
 delivering a force to the insert, such that at least one slot of the insert reduces in size as the insert is compressed into the at least one slot. 
 
     
     
       2. The method of  claim 1 , wherein the insert is configured to lock the bone screw at the selected angle without the use of a set screw. 
     
     
       3. The method of  claim 1 , further comprising:
 adjusting the angle of the bone screw relative to the intramedullary nail by causing at least a portion of the insert to rotate about a rotational axis transverse to the longitudinal axis of the intramedullary nail. 
 
     
     
       4. The method of  claim 1 , wherein the insert is configured to deform around the bone screw to lock the bone screw at the selected angle. 
     
     
       5. The method of  claim 1 , further comprising:
 passing the bone screw through a second elongated opening of the through bore defined by the intramedullary nail. 
 
     
     
       6. The method of  claim 1 , further comprising:
 drilling a hole through the insert at the selected angle. 
 
     
     
       7. The method of  claim 6 , wherein the hole comprises a pilot hole. 
     
     
       8. The method of  claim 1 , wherein inserting the bone screw through the insert comprises drilling the bone screw into the insert. 
     
     
       9. The method of  claim 1 , wherein the selected angle differs from at least one other angle of the plurality of angles in two dimensions. 
     
     
       10. The method of  claim 1 , further comprising:
 implanting the intramedullary nail into an anatomy of a patient. 
 
     
     
       11. The method of  claim 1 , wherein the insert comprises a resorbable material. 
     
     
       12. A method, comprising:
 inserting a bone screw through first and second openings in an intramedullary nail and an insert positioned completely within a lumen extending along a longitudinal axis of the intramedullary nail; and 
 causing a slot of the insert reduce in size to lock the bone screw at a selected angle. 
 
     
     
       13. The method of  claim 12 , further comprising:
 positioning the bone screw at the selected angle, wherein the selected angle is selected from a plurality of possible angles relative to the intramedullary nail. 
 
     
     
       14. The method of  claim 12 , wherein positioning the bone screw comprises causing at least a portion of the insert to rotate about a rotational axis transverse to the longitudinal axis of the intramedullary nail. 
     
     
       15. The method of  claim 12 , wherein causing the slot of the insert to reduce in size comprises delivering a force to deform the insert. 
     
     
       16. The method of  claim 15 , wherein deforming the insert comprises actuating a locking mechanism configured to deliver a force to the insert. 
     
     
       17. A method, comprising:
 selecting a selected angle of a plurality of angles permitted by a through bore defined by an intramedullary nail; 
 passing a bone screw through a first opening of the through bore; 
 passing the bone screw through an insert positioned completely within a lumen extending along a longitudinal axis of the intramedullary nail; 
 passing the bone screw through a second opening of the through bore; and 
 causing the insert to deform to lock the bone screw at the selected angle. 
 
     
     
       18. The method of  claim 17 , further comprising:
 causing the insert to rotate to adjust the angle of the bone screw relative to the intramedullary nail to the selected angle.